{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T20:28:31Z","timestamp":1764793711333},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,11,5]],"date-time":"2010-11-05T00:00:00Z","timestamp":1288915200000},"content-version":"vor","delay-in-days":308,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>HIV viral load testing as a component of antiretroviral therapy monitoring is costly. Understanding the full costs and the major sources of inefficiency associated with viral load testing is critical for optimizing the systems and technologies that support the testing process. The objective of our study was to estimate the costs associated with viral load testing performed for antiretroviral therapy monitoring to both patients and the public healthcare system in a low\u2010HIV prevalence, low\u2010resource country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A detailed cost analysis was performed to understand the costs involved in each step of performing a viral load test in Nicaragua, from initial specimen collection to communication of the test results to each patient's healthcare provider. Data were compiled and cross referenced from multiple information sources: laboratory records, regional surveillance centre records, and scheduled interviews with the key healthcare providers responsible for HIV patient care in five regions of the country.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total average cost of performing a viral load test in Nicaragua varied by region, ranging from US$99.01 to US$124.58, the majority of which was at the laboratory level: $88.73 to $97.15 per specimen, depending on batch size. The average cost to clinics at which specimens were collected ranged from $3.31 to $20.92, depending on the region. The average cost per patient for transportation, food, lodging and lost income ranged from $3.70 to $14.93.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The quantitative viral load test remains the single most expensive component of the process. For the patient, the distance of his or her residence from the specimen collection site is a large determinant of cost. Importantly, the efficiency of results reporting has a large impact on the cost per result delivered to the clinician and utility of the result for patient monitoring. Detailed cost analysis can identify opportunities for removing barriers to effective antiretroviral therapy monitoring programmes in limited\u2010resource countries with low HIV prevalence.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1758-2652-13-43","type":"journal-article","created":{"date-parts":[[2010,11,5]],"date-time":"2010-11-05T19:16:10Z","timestamp":1288984570000},"page":"43-43","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cost analysis of centralized viral load testing for antiretroviral therapy monitoring in Nicaragua, a low\u2010HIV prevalence, low\u2010resource setting"],"prefix":"10.1002","volume":"13","author":[{"given":"Jay","family":"Gerlach","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magda","family":"Sequeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivian","family":"Alvarado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Cerpas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Balmaseda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alcides","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tala","family":"de los Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol E","family":"Levin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jose","family":"Amador","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo J","family":"Domingo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060247"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181a4f9c4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328137709e"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030004"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181d0db97"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/653119"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-8-89"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/600396"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/600397"},{"key":"e_1_2_10_11_1","unstructured":"GuptaRK HillA SawyerAW Cozzi\u2010LepriA vonWylV YerlyS LimaVD GunthardHF GilksC PillayD:Virological monitoring and resistance to first\u2010line highly active antiretroviral therapy in adults infected with HIV\u20101 treated under WHO guidelines: a systematic review and meta\u2010analysis."},{"issue":"7","key":"e_1_2_10_12_1","first-page":"409","article-title":"Challenges for Rapid Molecular HIV Diagnostics","volume":"9","author":"Schito ML","journal-title":"The Journal of Infectious Diseases 2010, 201(s1): S1\u2010S6. 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